Cortico-anorectal, Spino-anorectal, and Cortico-spinal Nerve Conduction and Locus of Neuronal Injury in Patients With Fecal Incontinence

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Xuelian XiangSatish S C Rao

Abstract

The neuropathophysiology of fecal incontinence (FI) is incompletely understood. We examined the efferent brain-anorectal and spino-anorectal motor-evoked potentials (MEP) to characterize the locus of neuronal injury in patients with FI. We performed bilateral transcranial, translumbar, and transsacral magnetic stimulations in 27 patients with FI (19 female) and 31 healthy individuals (controls, 20 female) from 2015 through 2017. MEPs were recorded simultaneously from the rectum and anus using 4 ring electrodes. The difference in MEP latencies between the transcranial (TMS) and translumbar transsacral magnetic stimulations was calculated as cortico-spinal conduction time. MEP data were compared between patients with FI and controls. Patients filled out questionnaires that assessed the severity and effects of FI. The MEP latencies with TMS were significantly longer in patients with FI than controls at most sites, and on both sides (P < .05). Almost all translumbar and transsacral MEP latencies were significantly prolonged in patients with FI vs controls (P < .01). The cortico-spinal conduction time were similar, on both sides, between patients with FI and controls. Ninety-three percent of patients had 1 or more abnormal translumb...Continue Reading

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Citations

May 15, 2020·Alimentary Pharmacology & Therapeutics·Satish S C RaoAmol Sharma
Jun 25, 2020·Therapeutic Advances in Gastroenterology·Yoav MazorAllison Malcolm
Aug 3, 2020·The American Journal of Gastroenterology·Satish S C RaoShaheen Hamdy
Jul 29, 2020·Gastroenterology Clinics of North America·Alice C JiangSatish S C Rao
Jun 23, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Satish S C RaoShaheen Hamdy
Oct 22, 2021·Diseases of the Colon and Rectum·Yun YanSatish S C Rao

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